503776 - NURSING IN CRITICAL AREA

GENERAL ASPECTS OF THE CRITICAL AND EMERGENCY AREA The student will be able to describe the specificities of the critical area and the skills characterising the nurse working in critical care settings. He/she will be able to describe the minimum structural and technological requirements of emergency areas and define quality standards in intensive care.
Historical background Definition and fundamental components of the critical area, vital criticality Skills characterising the critical area nurse Organisational and structural characteristics in the critical area Complexity of care Humanisation of care Quality standards, structure, process and outcome indicators ABCDE approach GENERAL PRINCIPLES OF CRITICAL CARE The student will be able to describe the alterations related to admission to intensive care: physical, mental and emotional symptoms which persist after discharge from the ICU. He/she will acquire knowledge of preventive and rehabilitative interventions in the ICU delirium, pain management, sedation, early mobilisation and rest and sleep.
Pain management Delirium and neuromuscular syndrome Pain-acting-delirium triad Pain assessment scales, delirium, sedation Sleep management Early mobilisation CLINICAL ASSISTANCE CASE DISCUSSION: THE CRITICAL PATIENT WITH HEMODINAMIC AND CARDIOLOGICAL PROBLEMS: The student starting from a clinical case will acquire the knowledge to manage and educate the patient with rhythm disturbances or heart failure/shock.
Clinical monitoring and assessment Pain management Life-threatening cardiac rhythms Arterial catheter management and invasive BP monitoring CVC management, PVC monitoring, safe drug therapy administration Hints on organ replacement ultrafiltration, dialysis, ECMO The emergency trolley Induced therapeutic hypothermia THE EXTRA-OSPEDALIAN RESCUE, THE NETWORKS AND THE PRINCIPLES OF ASSESSMENT OF THE PERSON WITH TRAUMA (COSI): The student, starting from a clinical case (polytrauma patient), will be able to activate the chain of rescue, applicable then to any working and non-working environment in which he/she will operate. The student will be able to analyse and understand the clinical picture presented, understand how to activate rescue, scene safety issues, perform an assessment of the person in a critical state using the knowledge and tools, as well as the diagnostic and therapeutic paths presented in the classroom.
The Territorial Emergency-Urgency System The Health Alarm System The Territorial Rescue System ABCDE assessment and head and foot networks of time-dependent pathologies THE CONCEPT OF PRIORITY IN THE CRITICAL PATIENT AND THE EMERGENCY DEPARTMENTS (COSI): In this session, starting from real cases in Triage, the method of "global assessment" is developed. The aim is to convey to the student through clinical cases the ability to stratify intervention priorities and establish an implementation and re-evaluation pathway based on the evolutionary risk of the person using standardised assessment tools to be applied in situations where he/she has to manage a large number of patients, also applicable in ordinary inpatient settings. Rapid assessment method of care needs, Triage: The context of Emergency Departments: PS, Short Intensive Observation, Emergency Medicine.
Triage: Definitions, evidence and regulations Triage models and Global Triage Priority codes and pathways, vital parameters Fragile patients The triage document system Reassessment Characteristics of the triage nurse Early detection of signs and symptoms involving a potential or immediate risk to life: codes 1 and time-dependent pathologies (clinical cases) Tools for assessing the clinical and developmental risk of individuals: NEWS/NEWS2 (Modified Early Warning Score) assessment scales, APACHE II (acute physiologic assessment and chronic health evaluation), QSOFA/SOFA (sequential organ failure assessment score), SAPS II (Simplified Acute Physiology Score II), RTS (Revised Trauma Score), CPS (Chest Pain Score).
Outlines on the use of ultrasound in the person's care practice CLINICAL CASE DISCUSSION: THE PERSON WITH ACUTE BREATHING SUPPORT (COSI) Starting from the data collection of a clinical case of a person with acute respiratory problems, the aim is to deepen the assessment, planning and implementation of care and the evaluation of the results by motivating the main interventions related to the needs of the person under treatment with HFNC, CPAP and NIV, declining all the care needs. In addition, the student will acquire the basic knowledge to choose the type of monitoring, the frequency and its limitations, and to include them within the overall evaluation.